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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 342700494
Report Date: 11/04/2022
Date Signed: 11/08/2022 02:30:25 PM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2525 NATOMAS PARK DR. STE.270
SACRAMENTO, CA 95833
This is an official report of an unannounced visit/investigation of a complaint received in our office on
08/25/2022 and conducted by Evaluator Christina Valerio
PUBLIC
COMPLAINT CONTROL NUMBER: 27-AS-20220825092037
FACILITY NAME:TELECARE HERALD HOUSEFACILITY NUMBER:
342700494
ADMINISTRATOR:BURTON, ANASTASIAFACILITY TYPE:
738
ADDRESS:12956 ALTA MESA RDTELEPHONE:
(209) 748-2513
CITY:HERALDSTATE: CAZIP CODE:
95638
CAPACITY:4CENSUS: 4DATE:
11/04/2022
UNANNOUNCEDTIME BEGAN:
11:30 AM
MET WITH:Ona BerardTIME COMPLETED:
12:30 PM
ALLEGATION(S):
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Staff did not ensure facility was free from pests
Facility bathroom is dirty
Facility bathroom does not have paper towels
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Christina Valerio arrived to the facility unannounced to deliver complaint investigation findings. LPA met with Officer Coordinator 1, Ona B. and explained the purpose of the visit.

LPA Valerio conducted facility observations on 09/01/22, 09/26/22, 10/19/22, and 11/04/22. During each observation, the facility bathrooms were stocked with paper towels, toilet paper, soap, and a lidded trash can. The inside of the home was observed to be free from pest. The facility is on a plot of land in the city of Herald. The land surrounding the facility is grassy fields and neighboring residential homes. With this setting, bugs and other pest do co-exist. When LPA walked around the home during the observations dates, bugs were observed outside of the facility. Most of the bugs appeared to be dead as evidenced by the bug on it back, legs not moving, and appeared to be dried.

Continues on LIC 9099 - C...
This document was ameded to change from confidential to public
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Stephen Richardson
LICENSING EVALUATOR NAME: Christina Valerio
LICENSING EVALUATOR SIGNATURE:

DATE: 11/04/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/04/2022
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 1 of 2
Control Number 27-AS-20220825092037
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2525 NATOMAS PARK DR. STE.270
SACRAMENTO, CA 95833
FACILITY NAME: TELECARE HERALD HOUSE
FACILITY NUMBER: 342700494
VISIT DATE: 11/04/2022
NARRATIVE
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Continued from LIC 9099

According to staff interviews, staff or residents will take initiative to sweep the bugs. According to staff interview, "We can see random bugs: rolly pollies, ants, black widows, or beetles. They are usually by the bathroom windows or near the doors. The facility has pest control come every 2 weeks and as needed. Usually, after the pest control people spray, there will be dead bugs on their backs. The facility will sweep them up and put them in the trash. "

According to an interview with the administrator, the facility has regular routine pest control that services the home. Based on records review, invoices from Fast Action Pest Control confirm that the facility has a routine schedule service.

Based on all the information collected by the Department there is not a preponderance of evidence to prove the allegation occurred, therefore this allegation is UNSUBSTANTIATED.  Due to the above noted information, although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation(s) did or did not occur, and therefore the allegations are unsubstantiated. Per California Code of Regulations (CCRs) - Title 22,  no deficiencies cited.
SUPERVISORS NAME: Stephen Richardson
LICENSING EVALUATOR NAME: Christina Valerio
LICENSING EVALUATOR SIGNATURE:

DATE: 11/04/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/04/2022
LIC9099 (FAS) - (06/04)
Page: 2 of 2